Bertelsen S, Malmstrom J, Heerfordt J, Pedersen H
Thorax. 1975 Feb;30(1):19-25. doi: 10.1136/thx.30.1.19.
Fifty-three patients operated on between 1952 and 1971 were originally diagnosed as having thymoma. Re-examination of the material shows that only half of these tumours were true thymomas. The rest were classified as malignant lymphomas, primary and secondary carcinomas, and a few haemangiomas. Half of the patients had symptoms at the time of diagnosis. However, in half of the asymptomatic cases the tumours had penetrated the capsule. Decisive in prognosis are the macroscopic findings around the capsule. Of 33 patients with infiltration of the capsule, 30 had died at the time of investigation. Twenty-five patients died within two years of operation, Twenty-five patients had thymomas, of which 14 were well defined. Twelve patients with thymomas suffered from myasthenia gravis. The treatment of choice of thymoma is total excision, if necessary enbloc, and if there is penetration of the capsule, radiotherapy should be given. None of the patients with a well-defined thymoma had died from their tumour while only two patients with infiltrating thymomas are still alive, Of eight patients with Hodgkin's disease located in the thymus, six had penetration of the capsule, and of these only one patient is still alive. Two patients with well-defined tumours are both alive. The treatment of localized Hodgkin's disease is excision and irradiation. The prognosis for patients with other malignant tumours was bad, the mean time of survival being less than six months.
1952年至1971年间接受手术的53例患者最初被诊断为胸腺瘤。对这些病例资料的重新检查显示，这些肿瘤中只有一半是真正的胸腺瘤。其余的被归类为恶性淋巴瘤、原发性和继发性癌以及少数血管瘤。一半的患者在诊断时有症状。然而，在一半无症状的病例中，肿瘤已穿透包膜。预后的决定性因素是包膜周围肉眼可见的表现。在33例包膜受侵的患者中，30例在调查时已经死亡。25例患者在手术后两年内死亡。25例患者患有胸腺瘤，其中14例边界清晰。12例胸腺瘤患者患有重症肌无力。胸腺瘤的首选治疗方法是完整切除，必要时整块切除，如果包膜受侵，则应进行放疗。边界清晰的胸腺瘤患者中无一例死于肿瘤，而只有2例浸润性胸腺瘤患者仍然存活。8例位于胸腺的霍奇金病患者中，6例包膜受侵，其中只有1例患者仍然存活。2例边界清晰肿瘤的患者均存活。局限性霍奇金病的治疗方法是切除和放疗。其他恶性肿瘤患者的预后很差，平均生存时间不到6个月。
